Doctor Name: | DAVID HENRY CLOUD |
NPI Number: | 1831229772 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01013236A |
Business Practice Address: | 1098 S St. Rd 25 Logansport, IN - 469476723 |
Business Phone Number: | 5747224141 |
Business Fax Number: | |
Mailing Address: | Po Box 11503, 405 Bass Street FORT WAYNE |
State: | IN |
Postal Code: | 46858 |
Phone Number: | 2604384341 |
Fax Number: | |
NPI Enumeration Date: | 03/07/2007 |
NPI Last Update Date: | 09/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01013236A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |